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NPI Code Detail

MEDICARE: DR. JOHN C HOUSE M.D.

MEDICARE: DR. JOHN C HOUSE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician053549GA

General Provider Information

NPI Number : 1538138805
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN C HOUSE M.D.
Provider Business Mailing Address
First Line : 1300 CLEVELAND AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-2005
Country : US
Telephone Number : 423-756-7860
Fax Number : 423-756-9137
Provider Business Practice Location Address
First Line : 1300 CLEVELAND AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-2005
Country : US
Telephone Number : 423-756-7860
Fax Number : 423-756-9137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 01/06/2009

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